Different factors underlie recurrent and de novo organ involvement in immunoglobulin G4-related disease.
Different factors underlie recurrent and de novo organ involvement in immunoglobulin G4-related disease.
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免疫球蛋白 G4 相关疾病的复发性和新发器官受累有不同的因素。
DOI：
10.1093/rheumatology/kez321
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Kawano M.
中科院分区：
文献类型：
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作者：
Mizushima I;Tsuge S;Fujisawa Y;Hara S;Suzuki F;Ito K;Fujii H;Yamada K;Kawano M.
目的IgG 4相关疾病（IgG 4-RD）在临床过程中经常发生复发，包括复发性器官受累（ROI）和新发器官受累（DNOI）。本研究旨在阐明IgG 4-RD中ROI和DNOI相关风险因素之间的差异。方法我们回顾性调查了86例IgG 4-RD患者中与ROI和DNOI相关的因素。为了评估与ROI和DNOI相关的因素，我们进行了单因素和多因素考克斯回归分析。在逐步多因素分析中，我们应用的变量与P < 0.1的单因素分析和复发的预测在过去的reports.ResultsDuring平均随访期为63.1个月，ROI检测在1.0-120个月后诊断20例，其中4人没有接受糖皮质激素（GC）的时间感兴趣。相反，15例患者在诊断后5.0-120个月检测到DNOI，其中8例在DNOI时未接受GC。在多变量分析中，诊断时血嗜酸性粒细胞计数[每100/μl;风险比（HR）1.072（95%CI 1.018，1.129）]和继续GC [vs.停止或观察无GC; HR 0.245（95% CI 0.076，0.793）]对至DNOI的时间有显著影响，而年龄[HR 0.942（95% CI 0.899，0.986）]和ANA阳性[vsnegativity; HR 6.632（95%CI 1.892，23.255）]对ROI的时间有显著影响。结论本研究表明，在IgG 4-RD中，ROI和DNOI的危险因素不同，强调需要不同的预防策略。
ObjectivesIn IgG4-related disease (IgG4-RD), relapse including recurrent organ involvement (ROI) and de novo organ involvement (DNOI) occurs frequently during the clinical course. This study aimed to clarify the differences between the risk factors underlying ROI and DNOI in IgG4-RD.MethodsWe retrospectively investigated factors related to ROI and DNOI in 86 IgG4-RD patients. For assessment of factors related to ROI and DNOI, we performed uni- and multivariate Cox regression analyses. On stepwise multivariate analysis, we applied the variables withP< 0.1 in the univariate analysis and the predictors of relapse suggested in past reports.ResultsDuring the mean follow-up period of 63.1 months, ROI was detected at 1.0–120 months after diagnosis in 20 patients, 4 of whom were not receiving glucocorticoid (GC) at the time of ROI. In contrast, DNOI was detected at 5.0–120 months after diagnosis in 15 patients, 8 of whom were not receiving GC at the time of DNOI. In the multivariate analysis, blood eosinophil counts at diagnosis [per 100/μl; hazard ratio (HR) 1.072 (95% CI 1.018, 1.129)] and continuation of GC [vsdiscontinuation or observation without GC; HR 0.245 (95% CI 0.076, 0.793)] had a significant impact on the time to DNOI, whereas age [HR 0.942 (95% CI 0.899, 0.986)] and ANA positivity [vsnegativity; HR 6.632 (95% CI 1.892, 23.255)] had a significant impact on the time to ROI.ConclusionThe present study suggests that the risk factors of ROI and DNOI are different in IgG4-RD, highlighting the need for different preventative strategies.